| NPI | 1215151394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 78999) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 1731352) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2024-09-30 |